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CPT code 25101: Wrist arthrotomy2026 Medicare rate & RVUs

Report open wrist joint exploration, drainage, or foreign body removal when the surgeon enters the joint to evaluate or treat an identified problem.

CMS RVU26DEffective Oct 1, 2026109 payment localities402 Medicare services in 2024

Medicare pays $392.13 for 25101 nationally in a facility.

Medicare rate · 25101

Wrist arthrotomy

Work RVUs
4.71
Total RVUs
11.74
Global days
090

National rate · 2026

$392.13

Facility setting, before claim adjustments.

See every locality for 25101 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 25101 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 25101 covers

This service involves opening the wrist joint through an incision so the surgeon can inspect the joint, drain it, or remove a foreign body. It may be performed by an orthopedic or hand surgeon in a hospital or ambulatory surgery setting. The operative report should identify the wrist joint and describe the findings and the work performed, such as the exploration, drainage, or foreign body extraction.

Report this code when the documented procedure matches that open joint work; a biopsy or removal of synovial tissue is a different service. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 25101 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

25101 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$353.28
Alaska*Unavailable$470.25
ArizonaUnavailable$381.38
ArkansasUnavailable$348.45
AtlantaUnavailable$402.04
AustinUnavailable$400.77
BakersfieldUnavailable$402.69
Baltimore/Surr. CntysUnavailable$416.82
BeaumontUnavailable$371.58
BrazoriaUnavailable$384.79

25101 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
25101 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 25101 rate is calculated

Each of 25101’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 25101

RVUs × geographic indexes × conversion factor

Work4.71

4.71 RVUs× 1.000 GPCI

Practice expense6.11

6.11 RVUs× 1.000 GPCI

Malpractice0.92

0.92 RVUs× 1.000 GPCI

Adjusted RVUs

11.7400

Conversion factor

$33.4009

Medicare rate

$392.13

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 25101

25101 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 25101

Wrist arthrotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 25101

Wrist arthrotomy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

25101 without 50 · national facility

$392.13

Wrist arthrotomy

25101-50 · Bilateral: 150%

$588.20

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

25101 compared with similar codes

Compare codes · National

4 codes, side by side

  • 25101

    Wrist arthrotomy4.71 wRVU

    Not priced

  • 25100

    Wrist biopsy3.92 wRVU

    Not priced

  • 25105

    Wrist synovectomy5.87 wRVU

    Not priced

  • 25107

    Wrist cartilage excision7.51 wRVU

    Not priced

How to choose

25100Wrist biopsy
Choose 25100 when the wrist arthrotomy is performed to obtain a joint biopsy. Choose 25101 for exploration, drainage, or foreign body removal instead.
25105Wrist synovectomy
25105 describes wrist joint synovectomy. 25101 applies when the documented work is exploration, drainage, or foreign body removal rather than synovial lining excision.
25107Wrist cartilage excision
25107 is for removal of wrist joint cartilage. It is not the code for general joint exploration, drainage, or foreign body removal.

Codes related to 25101

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 25101
CodeHow it relatesNational office range
Same family
25100Wrist biopsyWrist arthrotomy for biopsy rather than exploration, drainage, or foreign body removal.No office rate
Used instead
25105Wrist synovectomySelected for wrist joint synovectomy when removal of synovial lining is performed.No office rate
25107Wrist cartilage excisionA separate wrist joint procedure for removal of joint cartilage.No office rate

25101 billing questions

How does this differ from 25100?

25101 is for open exploration, drainage, or foreign body removal from the wrist joint. Use 25100 when the arthrotomy is performed for a joint biopsy.

When is 25105 more appropriate?

Use 25105 when the surgeon performs a wrist joint synovectomy, removing synovial lining. Exploration or drainage without that synovectomy is the work described by 25101.

What should the operative note document?

Document the wrist joint entered, the reason for the arthrotomy, and whether the surgeon explored the joint, drained it, or removed a foreign body.

How is bilateral surgery reported?

For bilateral wrist procedures, report modifier 50; CMS pays this code at 150% when reported bilaterally.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

How does the multiple-procedure reduction affect payment?

When this procedure is performed with other procedures in the same session, CMS pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 25101PPRRVU2026_Oct_nonQPP.csv, line 2,388 (RVU26D)

Open CMS sourceHow we calculate rates

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